Preparing for the frontlines: training for a high pressure Ebola mission in Sierra Leone

Published: 19 September 2014 12:51 CET

Workers preparing to deploy to the IFRC Ebola treatment centre in Kenema, Sierra Leone practice safe handling of bodies in a simulation in Geneva. They will treat as many as 60 patients at a time in one of the most affected communities of the outbreak.

Workers preparing to deploy to the IFRC Ebola treatment centre in Kenema, Sierra Leone practice dressing in personal protective equipment in Geneva. They will treat as many as 60 patients at a time in one of the most affected communities of the outbreak

British Red Cross worker Dr Alex Kumar learns the extensive process of dressing in personal protective equipment as part of the Ebola pre-deployment training in Geneva. He will prepare to work with patients in the Ebola treatment centre in Kenema, Sierr

Twenty-six Red Cross Red Crescent workers from seven countries underwent a rigorous two-day training in Geneva this week. As part of the International Red Cross and Red Crescent Society’s most recent response phase, they will operate a treatment centre for Ebola virus disease patients.

They will be among the first health workers to treat patients in the heart of the Ebola outbreak at the IFRC’s newly-constructed Ebola treatment centre in Kenema, Sierra Leone. The centre will admit 60 patients gradually over the next few weeks, as it scales up operations to support the nation’s overwhelmed health facilities. More than 1,400 Ebola cases and 524 deaths have been counted in Sierra Leone alone.

The first contingent of workers left for Sierra Leone immediately following their training. They are doctors, nurses, paramedics, health advisers and sanitation specialists. Some have worked in outbreaks before, but everyone needs the new level of training for this operation. Delivering treatment is a completely new component of the IFRC response in the outbreak. The government of Sierra Leone requested Red Cross assistance since the capacity of area hospitals is overwhelmed.

Over the course of 48 hours, the workers were immersed in a series of sessions taught by IFRC health experts who have recently returned from West Africa. The training covered symptoms and transmission of the Ebola virus disease, but above all, the training emphasized that workers must put their personal safety first in order to remain healthy and able to treat patients.

Trainees went through drills from setting up a safe treatment centre and managing the flow of patients and staff to handling highly-contagious bodies, disinfecting ambulances, and disposing of waste. One component emphasized the need for culturally sensitivity, as they will be entering a community riddled with fear and anxiety. Every action has a multi-step process. It is physically and mentally exhausting.

“It will be like working under the leadership of an air traffic controller,” Panu Saaristo, IFRC Senior Officer for Emergency Health told them. Many are leaving the comfort of high-resource medical centres to work in a facility that operates on the basics and under exceptionally strict protocols. They were instructed to leave all stethoscopes and personal equipment at home. They will use their fingers to take pulses and feel for heartbeats.

They will take no shortcuts when it comes to protecting themselves on this “no-touch mission,” having been instructed not to touch anyone without wearing protective gear, including themselves, the entire time in the field. Working in pairs, they will be each other’s eyes, ears, and lifelines while treating patients in high-risk areas.

The trainees found getting dressed in protective suits, masks, goggles and aprons takes at least 20 minutes. Sweat drips and goggles fog after only moments, which is nothing compared to the heat they’ll endure inside Kenema’s stifling treatment centre. Under these conditions, they will be required to rotate shifts every 45 minutes to one hour to help prevent the fatigue that can result in life-threatening mistakes.

They will douse their hands in chlorine solution after handling anything even slightly hazardous. When managing corpses, this can happen up to 15 times in the course of a few minutes, significantly more than for normal procedures. No chances will be taken.

Alex Kumar, a trainee from the British Red Cross, has served in high-pressure medical responses before and explains, “None of the mistakes happen when you first arrive. They happen three weeks in when you are so tired you forget to think.” It is a new level of precaution that will become a lifestyle for the duration of their mission, and it will take every ounce of energy to enforce.

The pioneering group will be followed by more Red Cross Red Crescent workers entering the field over the next several months to work in the Kenema treatment centre. Case loads are expected to increase.

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